vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v13i3.1023vsp-187Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWОСТРЫЕ КИШЕЧНЫЕ ИНФЕКЦИИ У ДЕТЕЙ В ПРАКТИКЕ ПЕДИАТРА: ВОЗМОЖНОСТИ ДИАГНОСТИКИ И ТЕРАПИИCHILDREN ACUTE ENTERIC INFECTIONS IN PAEDIATRICIAN PRACTICE: POSSIBILITIES OF DIAGNOSTICS AND THERAPYУсенкоД. В.UsenkoD. V.

Usenko Denis Valerievich, PhD, senior research scientist of Clinical Department of Infectious Pathology

dusenko@rambler.ruПлоскиреваА. А.PloskirevaА. А.dusenko@rambler.ruГореловА. В.GorelovA. V.dusenko@rambler.ruЦентральный НИИ эпидемиологии, МоскваРоссияCentral Research Institute of Epidemiology, MoscowRussian Federation201419062014133Вопросы современной педиатрии1220Copyright © Усенко Д.В., Плоскирева А.А., Горелов А.В., 20142014Усенко Д.В., Плоскирева А.А., Горелов А.В.Usenko D.V., Ploskireva А.А., Gorelov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/187

Острые кишечные инфекции (ОКИ) занимают одно из ведущих мест в структуре инфекционной патологии в детском возрасте. Разнообразие этиологических агентов (бактерии, вирусы и простейшие), вызывающих инфекционную диарею, высокая частота микст-инфекций, нередкие неблагоприятные исходы и негладкое течение обосновывают необходимость поиска путей оптимизации диагностических и терапевтических подходов в соответствии с современными научными данными. В статье рассмотрены принципы клинической и лабораторной диагностики ОКИ. Представлены критерии оценки степени тяжести заболевания, прогностические критерии развития жизнеугрожающих состояний, связанных с эксикозом. С современных позиций представлены принципы лечения ОКИ, подчеркивается необходимость комплексного подхода и этапности в терапии с персонифицированным выбором препаратов, учитывающим тяжесть, фазу и клиническую форму болезни, возраст ребенка и состояние макроорганизма к моменту начала заболевания. Подчеркнута необходимость строго дифференцированного подхода к назначению антибиотиков. Отдельно представлены данные о целесообразности включения пробиотиков в стартовую терапию ОКИ вирусной этиологии с учетом штаммоспецифической эффективности, что обеспечивает достоверное уменьшение степени выраженности и длительности основных симптомов заболевания, а также оказывает благоприятное влияние на состояние микрофлоры желудочно-кишечного тракта.

Acute Enteric Infections (AEI) occupy one of the leading places in structure of infectious pathology at children's age. A variety of etiological agents (bacteria, viruses and protozoa) causing infectious diarrhoea, the high frequency of mixed infections, frequent failures and uneven course prove the necessity of search of ways for optimization of diagnostic and therapeutic approaches according to modern scientific data. The principles of clinical and laboratory diagnostics of AEI are considered in the article. Criteria of the assessment of a disease severity, predictive criteria of development of the life-threatening states connected with the exicosis are presented. The principles of AEI treatment are presented from the modern positions, the necessity of an integrated approach and staging in therapy with the personified choice of preparations considering weight, phase and clinical form of a disease, age of a child and a macroorganism condition by the time of the disease beginning are introduced. The necessity of a strictly differentiated approach to prescription of antibiotics is emphasized. The data on expediency of inclusion of probiotics to starting AEI therapy of virus aetiology are separately presented taking into account strain-specific efficiency that provides the reliable reduction of degree of intensity and duration of the main symptoms of a disease, and also has beneficial impact on a condition of microflora of a gastrointestinal path.

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The authors declare that there are no conflicts of interest present.